Retrospective Cohort Study
Copyright ©The Author(s) 2025.
World J Transplant. Sep 18, 2025; 15(3): 100111
Published online Sep 18, 2025. doi: 10.5500/wjt.v15.i3.100111
Table 1 Baseline demographics and clinical characteristics of study cohort, n (%)
Characteristics
Total (n = 70)
Normal acid exposure (n = 52)
Increased acid exposure (n = 18)
P value
Follow up, (years), mean ± SD2.23 ± 1.872.24 ± 2.032.22 ± 1.340.97
Male sex41 (58.6)30 (57.7)11 (61.1)1.00
BMI, mean ± SD26.8 ± 4.5627.4 ± 4.4025.4 ± 4.800.11
Age at transplant, mean ± SD56.3 ± 12.556.7 ± 12.555.0 ± 13.00.62
White race67 (95.7)51 (98.1)16 (88.9)0.16
Pulmonary diagnosis
ILD40 (57.1)28 (53.8)12 (66.7)0.41
IPF22 (31.4)14 (26.9)8 (44.4)0.24
COPD15 (21.4)13 (25.0)2 (11.1)0.32
Other17 (24.3)13 (25.0)4 (22.2)1.00
Cardiac function, baseline
LVEF, mean ± SD60.9 ± 5.4860.3 ± 5.7262.7 ± 4.400.11
PaP, mean ± SD26.6 ± 9.3627.7 ± 10.323.5 ± 4.620.03
PCWP, (mm Hg), mean ± SD10.3 ± 4.9010.8 ± 5.188.82 ± 3.710.16
PVR (dynes/cm5), mean ± SD225 ± 134230 ± 145212 ± 91.90.64
Pulmonary function, baseline
FVC, mean ± SD2.00 ± 0.771.99 ± 0.672.03 ± 1.010.87
FVC, %-pred, mean ± SD0.49 ± 0.150.50 ± 0.160.46 ± 0.120.29
FEV1, mean ± SD1.36 ± 0.661.32 ± 0.591.47 ± 0.850.44
FEV1, %-pred, mean ± SD0.42 ± 0.190.43 ± 0.200.40 ± 0.180.63
FEV1/FVC, mean ± SD0.69 ± 0.230.68 ± 0.230.72 ± 0.220.62
Bilateral lung transplant36 (51.4)29 (55.8)7 (38.9)0.28
CMV mismatch18 (25.7)15 (28.8)3 (16.7)0.37
Increased risk donor11 (15.7)8 (15.4)3 (16.7)1.00
Post-transplant infection30 (42.8)23 (44.3)7 (38.9)0.79
Post-transplant PPI54 (77.1)38 (73.1)16 (88.9)0.21
≥ 20% FEV1 decline18 (25.7)11 (21.1)7 (38.9)0.21
Table 2 Baseline demographics of cohort demonstrated no association with forced expiratory volume in 1 decline on time-to-event analysis
Characteristics
Univariate hazard ratio for pulmonary function decline (95%CI)
P value
Male sex2.14 (0.67-6.87)0.20
BMI0.98 (0.87-1.09)0.70
Age at transplant1.00 (0.95-1.04)0.85
White race 0.59 (0.08-4.59)0.62
Pulmonary diagnosis
ILD2.29 (0.71-7.39)0.16
IPF2.73 (0.94-7.89)0.06
COPD0-
Other0.91 (0.28-2.94)0.87
Cardiac function, baseline
LVEF0.19 (0-4512)0.75
PaP (mm Hg)1.00 (0.95-1.06)0.85
PCWP (mm Hg)1.00 (0.90-1.11)0.98
PVR (dynes/cm5)1.00 (0.99-1.00)0.58
Pulmonary function, baseline
FVC1.14 (0.62-2.11)0.67
FVC, %-pred0.30 (0.01-9.66)0.49
FEV11.67 (0.84-3.32)0.14
FEV1, %-pred3.25 (0.24-43.9)0.37
FEV1/FVC6.21 (0.46-83.7)0.17
Bilateral lung transplant0.74 (0.25-2.16)0.59
CMV mismatch0.77 (0.21-2.76)0.69
Increased risk donor0.62 (0.08-4.84)0.65
Post-transplant infection1.40 (0.49-4.01)0.53
Post-transplant PPI1.57 (0.35-7.04)0.55
Table 3 Multichannel intraluminal impedance and pH measures and time to forced expiratory volume in 1 decline
CharacteristicsUnivariate hazard ratio for pulmonary function decline (95%CI)P valueMultivariate analyses (separate models controlling for age, sex, BMI)
P value
Elevated AET (> 4.2%)3.49 (1.15-10.6)0.033.37 (1.08-10.6)0.04
Elevated total reflux episodes (> 73)1.09 (0.34-3.48)0.891.45 (0.40-5.27)0.57
Elevated proximal acid episodes (> 28)3.34 (1.02-11.0)0.043.29 (0.90-12.1)0.07